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Minimally cardiac surgery

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https://www.readbyqxmd.com/read/28327076/myocardial-protection-during-minimally-invasive-cardiac-surgery-through-right-mini-thoracotomy
#1
Micaela De Palo, Pietro Guida, Florinda Mastro, Daniela Nanna, Teresa A P Quagliara, Ruggiero Rociola, Giosuè Lionetti, Domenico Paparella
BACKGROUND: Myocardial damage is an independent predictor of adverse outcome following cardiac surgery and myocardial protection is one of the key factors to achieve successful outcomes. Cardioplegia with Custodiol is currently the most used cardioplegia during minimally invasive cardiac surgery (MICS). Different randomized controlled trials compared blood and Custodiol cardioplegia in the context of traditional cardiac surgery. No data are available for MICS. AIM: The aim of this study was to compare the efficacy of cold blood versus Custodiol cardioplegia during MICS...
April 2017: Perfusion
https://www.readbyqxmd.com/read/28302745/current-status-and-future-potential-of-transcatheter-interventions-in-congenital-heart-disease
#2
Damien P Kenny, Ziyad M Hijazi
Percutaneous therapies for congenital heart disease have evolved rapidly in the past 3 decades. This has occurred despite limited investment from industry and support from regulatory bodies resulting in a lack of specific device development. Indeed, many devices remain off-label with a best-fit approach often required, spurning an innovative culture within the subspecialty, which had arguably laid the foundation for many of the current and evolving structural heart interventions. Challenges remain, not least encouraging device design focused on smaller infants and the inevitable consequences of somatic growth...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28295456/firth-s-logistic-regression-with-rare-events-accurate-effect-estimates-and-predictions
#3
Rainer Puhr, Georg Heinze, Mariana Nold, Lara Lusa, Angelika Geroldinger
Firth's logistic regression has become a standard approach for the analysis of binary outcomes with small samples. Whereas it reduces the bias in maximum likelihood estimates of coefficients, bias towards one-half is introduced in the predicted probabilities. The stronger the imbalance of the outcome, the more severe is the bias in the predicted probabilities. We propose two simple modifications of Firth's logistic regression resulting in unbiased predicted probabilities. The first corrects the predicted probabilities by a post hoc adjustment of the intercept...
March 12, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28291141/antegrade-cardioplegia-decannulation-using-the-cor-knot-system-in-minimally-invasive-mitral-valve-surgery
#4
Sabet W Hashim, Philip Y K Pang
A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding...
March 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28283470/rheumatic-fever-with-severe-carditis-still-prevalent-in-the-south-west-pacific
#5
Taran Kaur Nandra, Nigel J Wilson, John Artrip, Bruno Pagis
Rheumatic heart disease (RHD) has a worldwide prevalence of 33 million cases and 270 000 deaths annually, making it the most common acquired heart disease in the world. There is a disparate global burden in developing countries. This case report aims to address the minimal RHD coverage by the international medical community. A Tahitian boy aged 10 years was diagnosed with advanced heart failure secondary to RHD at a local clinic. Previous, subtle symptoms of changes in handwriting and months of fever had gone unrecognised...
March 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28269441/characteristic-of-a-force-sensing-guide-wire-for-minimally-invasive-cardiac-surgery
#6
N Stefanova, M Hessinger, T Opitz, R Werthschutzky
In minimal invasive cardiac surgery (MICS), the surgeon is missing haptic feedback of the guide wire for navigation through the vessels. A wide range of guide wires with various properties and performance characteristics are available to reduce the risk of complications during the intervention. This paper presents a force sensing guide wire for cardiac catheterization, which provides the surgeon a haptic feedback on the guide wire tip. Three conventional wires for the recanalization of chronic total coronary occlusions (CTO) are investigated and general design requirements for the force sensing guide wire are determined...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28257412/clinical-effect-and-prognosis-of-off-pump-minimally-invasive-direct-coronary-artery-bypass
#7
Ming Yang, Lian-Bo Xiao, Zhi-Sheng Gao, Ji-Wu Zhou
BACKGROUND Coronary artery bypass grafting (CABG) is a common procedure to circumvent the obstruction of coronary arteries when stents are unsuitable. CABG is a very traumatic surgery that requires redirecting blood flow to an external pump. Thus, this procedure has many risks during and after surgery, and minimizing these risks would greatly benefit the patients. MATERIAL AND METHODS We selected 126 patients with coronary artery syndrome and who were unsuitable for stent percutaneous coronary intervention...
March 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28254373/dosing-antibiotic-prophylaxis-during-cardiopulmonary-bypass-a-higher-level-of-complexity-a-structured-review
#8
REVIEW
Fathima Paruk, Fekade B Sime, Jeffrey Lipman, Jason A Roberts
In highly invasive procedures such as open heart surgery, the risk of post-operative infection is particularly high due to exposure of the surgical field to multiple foreign devices. Adequate antibiotic prophylaxis is an essential intervention to minimise post-operative morbidity and mortality. However, there is a lack of clear understanding on the adequacy of traditional prophylactic dosing regimens, which are rarely supported by data. The aim of this structured review is to describe the relevant pharmacokinetic/pharmacodynamic (PK/PD) considerations for optimal antibiotic prophylaxis for major cardiac surgery including cardiopulmonary bypass (CPB)...
February 27, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28243884/role-of-ct-in-congenital-heart-disease
#9
REVIEW
Prabhakar Rajiah, Sachin S Saboo, Suhny Abbara
Congenital heart diseases (CHD) are being increasingly encountered in cardiac imaging due to improved outcomes from surgical and interventional techniques. Imaging plays an important role in the evaluation of CHD, both prior to and after surgeries and interventions. Computed tomography (CT) has several advantages in the evaluation of these disorders, particularly its high spatial resolution, multi-planar reconstruction capabilities at sub-millimeter isotropic resolution, good temporal resolution, wide field of view, and rapid turnaround time, which minimizes the need for sedation and anesthesia in young children or children with disabilities...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28238200/left-cardiac-sympathetic-denervation-case-series-and-technical-report
#10
C McNamara, P Cullen, M Rackauskas, R Kelly, K E O'Sullivan, J Galvin, D Eaton
BACKGROUND: Left cardiac sympathetic denervation (LCSD) is a surgical procedure that has been shown to have an antiarrhythmic and antifibrillatory effect. Evidence indicating its antiarrhythmic effect has been available for over 100 years. It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure. With advancements in thoracic surgery, it can be safely performed via a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach resulting in significantly less morbidity and a shortened inpatient stay...
February 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28227687/characteristic-of-a-force-sensing-guide-wire-for-minimally-invasive-cardiac-surgery
#11
N Stefanova, M Hessinger, T Opitz, R Werthschutzky, N Stefanova, M Hessinger, T Opitz, R Werthschutzky, N Stefanova, M Hessinger, T Opitz
In minimal invasive cardiac surgery (MICS), the surgeon is missing haptic feedback of the guide wire for navigation through the vessels. A wide range of guide wires with various properties and performance characteristics are available to reduce the risk of complications during the intervention. This paper presents a force sensing guide wire for cardiac catheterization, which provides the surgeon a haptic feedback on the guide wire tip. Three conventional wires for the recanalization of chronic total coronary occlusions (CTO) are investigated and general design requirements for the force sensing guide wire are determined...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28216364/clinical-outcomes-of-obturator-canal-bypass
#12
Jonathan Bath, Maham Rahimi, Becky Long, Efthymios Avgerinos, Joseph Giglia
OBJECTIVE: Infected aortofemoral grafts pose a formidable challenge with a significant risk of limb loss and high mortality. Despite successful reports of obturator canal bypass (OCB) for infected aortofemoral graft and complicated groins, the technique has not gained widespread use. We reviewed our experience with OCB and performed a systematic review of the literature. METHODS: A retrospective review of patients who underwent OCB in our institution between 1995 and 2013 was conducted...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28210637/anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-an-uncommon-coronary-anomaly-with-serious-implications-in-adulthood
#13
Venkat Gangadharan, Kamesh Sivagnanam, Ghulam Murtaza, Michael Ponders, Otto Teixeira, Timir Paul
A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28203535/the-state-of-robotic-cardiac-surgery-in-europe
#14
Matteo Pettinari, Emiliano Navarra, Philippe Noirhomme, Herbert Gutermann
BACKGROUND: In the past two decades, the introduction of robotic technology has facilitated minimally invasive cardiac surgery, allowing surgeons to operate endoscopically rather than through a median sternotomy. This approach has facilitated procedures for several structural heart conditions, including mitral valve repair, atrial septal defect closure and multivessel minimally invasive coronary artery bypass grafting. In this rapidly evolving field, we review the status of robotic cardiac surgery in Europe with a focus on mitral valve surgery and coronary revascularization...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28201958/blood-infusion-and-the-risk-of-haemorrhage-in-patients-undergoing-cardiac-surgery-with-extracorporeal-circulation
#15
Manuel Luque-Oliveros, María Ángeles García-Carpintero, Omar Cauli
PURPOSE: Patients undergoing cardiac surgery with extracorporeal circulation (ECC) frequently present haemorrhages as a complication associated with high morbidity and mortality. One of the factors that influences this risk is the volume of blood infused during surgery. The objective of this study was to determine the optimal volume of autologous blood that can be processed during cardiac surgery with ECC. We also determined the number of salvaged red blood cells to be reinfused into the patient in order to minimize the risk of haemorrhage in the postoperative period...
February 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#16
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28159523/a-novel-automated-somatosensory-evoked-potential-ssep-monitoring-device-for-detection-of-intraoperative-peripheral-nerve-injury-in-cardiac-surgery-a-clinical-feasibility-study
#17
Jason Chui, John M Murkin, Timothy Turkstra, Neil McKenzie, Linrui Guo, Mackenzie Quantz
OBJECTIVE: Peripheral nerve injury (PNI) is a common and potentially devastating complication in cardiac surgery. Somatosensory evoked potential (SSEP) monitoring is one of the modalities for PNI; however, its application is limited by complicated logistics. This study aimed to assess the feasibility of using a novel, automated SSEP device (EPAD; SafeOp Surgical, Hunt Valley, MD) for detection of intraoperative PNI during cardiac surgery. DESIGN: Prospective, observational study...
November 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28154290/comparison-of-clinical-outcomes-after-transcatheter-vs-minimally-invasive-cardiac-surgery-closure-for-atrial-septal-defect
#18
Masaki Kodaira, Akio Kawamura, Kazuma Okamoto, Hideaki Kanazawa, Yugo Minakata, Mitsushige Murata, Hideyuki Shimizu, Keiichi Fukuda
BACKGROUND: Percutaneous closure has replaced surgery for the majority of cases of secundum atrial septal defect (ASD). However, technological advances have made contemporary minimally invasive cardiac surgery (MICS) less invasive than conventional surgery. The aim of this study was to compare clinical outcomes of percutaneous closure of secundum ASD with those of contemporary MICS.Methods and Results:We conducted a single-center retrospective study of 354 patients with ASD treated either with the Amplatzer Septal Occluder (134 patients) or MICS (220 patients) between 2000 and 2013...
February 1, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28147253/minimally-invasive-vs-open-congenital-diaphragmatic-hernia-repair-is-there-a-superior-approach
#19
Luke R Putnam, Kuojen Tsao, Kevin P Lally, Martin L Blakely, Tim Jancelewicz, Pamela A Lally, Matthew T Harting
BACKGROUND: The minimally invasive surgery (MIS) approach for congenital diaphragmatic hernia (CDH) repair remains controversial. Our objective was to compare outcomes and complications of the MIS and open approaches, with risk-stratification of patients based on defect size and key patient characteristics. STUDY DESIGN: The multinational CDH Study Group (CDHSG) registry was queried for the period from 2007 to 2015. Patient demographics and operative details, including the CDHSG Staging System defect size (A to D), were reviewed...
January 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28143731/patient-body-image-self-esteem-and-cosmetic-results-of-minimally-invasive-robotic-cardiac-surgery
#20
Taner İyigün, Mehmet Kaya, Sevil Özgül Gülbeyaz, Nurhan Fıstıkçı, Gözde Uyanık, Bilge Yılmaz, Burak Onan, Korhan Erkanlı
BACKGROUND: Patient-reported outcome measures reveal the quality of surgical care from the patient's perspective. We aimed to compare body image, self-esteem, hospital anxiety and depression, and cosmetic outcomes by using validated tools between patients undergoing robot-assisted surgery and those undergoing conventional open surgery. MATERIALS AND METHODS: This single-center, multidisciplinary, randomized, prospective study of 62 patients who underwent cardiac surgery was conducted at Hospital from May 2013 to January 2015...
January 29, 2017: International Journal of Surgery
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